Criteria for identifying the risk group for obstructive sleep apnea syndrome in operator professions

Abstract

Relevance. The diagnosis of obstructive sleep apnea syndrome (OSAS) is important in occupational health. The syndrome is accompanied by drowsiness during work and, thereby, creates serious prerequisites for reducing professional ability to work, the occurrence of production errors, accidents. The OSAS is closely related to clinical conditions: obesity, hypertension, cardiac arrhythmias, diabetes mellitus, which doctors take into account during periodic medical examinations when determining admission to work with harmful and/or dangerous production factors. For specialists in the operator professions, researchers consider OSAS as a threat to the health of employees and others.
 The study aims is to explore a set of criteria-based signs of OSAS risk for the scientific justification of the identification of target groups of workers subject to in-depth examination to establish/exclude this diagnosis.
 Materials and methods. We have conducted a comprehensive clinical and instrumental examination of 204 railway transport employees out of 986 examined in the hospital for expert purposes to detect increased daytime sleepiness (according to the Epworth index), OSAS, including polysomnography, cardiorespiratory monitoring (CRM). The specialists have analyzed the structure of the criteria risk signs by the method of the main components in the groups of workers of operator and non-operator professions.
 Results. According to polysomnography or CRM data, 118 employees had OSAS, including 51% of them with moderate to severe severity. Along with drowsiness and snoring , scientists have identified two groups of risk factors: 1) clinical — obesity (BMI>30 kg/m2), hypertension, diabetes mellitus, heart rhythm disturbances at night, gender; 2) professional — work experience, high intensity of work, work in night shifts. The sign of daytime sleepiness (according to the Epworth Sleepiness Scale) was insufficiently informative in both study groups. In the structure of clinical signs, the largest leading factors were: obesity, hypertension.
 Limitations. To assess drowsiness as a marker of OSAS, scientists used only the Epworth sleepiness scale; other questionnaires (for example, STOP-Bang, Stanford Sleepiness Scale, Karolinska Sleepiness Scale) were not used in this work.
 Conclusions. In operator professions, when conducting mandatory medical examinations, it is necessary to determine the risk of OSAS by a set of certain clinical and professional signs. When concluding that there is a risk of developing this condition, further in-depth examination is necessary to confirm the diagnosis.
 Ethics. The study was conducted in compliance with the Ethical principles of conducting medical research with the participation of a person as a subject, set out in the Helsinki Declaration of the World Medical Association of the last revision.